I failed 8 wk Harvoni treatment. Very disappointed. What now?

Failed 8 wks. Harvoni treatment. The word "failure" for the treatment not working, makes me feel like it is my fault. So disappointed. Doctor did not test viral loads, when I submitted blood after 4 wks., and 8 wks., even though I expressed concern about why he wouldn't test until 12 wks. after treatment. So bummed out.

I had treated three times with the old interferon treatments but had no response to treatment. After being infected for 30 years I was diagnosed with cirrhosis. Five years later the first of the new DAA’s were approved and I was treated with Sovaldi and Olysio for 22 weeks. I was not detected on treatment but at 12 weeks post I was found to have relapsed.

Really, on treatment means little except to confirm patient compliance. Nearly all patients are not detected or very nearly so there isn’t a reason to test as the results are basically known. The only test that matters is the 12 week after treatment ended to see if treatment has worked. All other testing is basically meaningless.

There is nothing you did that could have effected your treatment unless you simply did not take your meds. Simple put 98% is not 100% so unfortunately Harvoni is not perfect for everyone.

After my failure I was crushed but then Harvoni was approved. This time I treated for 24 weeks and we also added ribavirin this time. This last treatment finally worked and I was cured after being infected for 37 years on my fifth attempt.

I am now almost 3 years post treatment.

There are a couple of new treatments recently approved that are curing the few folks that have failed Harvoni. Just remember you did not fail Harvoni failed you.

Per the AASLD the recommendations currently for genotype 1 patients who failed treatment are:

“Recommended Regimen
Sofosbuvir/Velpatasvir/Voxilaprevir
The placebo-controlled, phase 3 POLARIS-1 trial evaluated a 12-week course of the daily fixed-dose combination of sofosbuvir (400 mg)/velpatasvir (100 mg)/voxilaprevir (100mg) in patients with a prior NS5A inhibitor-containing DAA regimen. The majority (61%) experienced a failure with a combination regimen of an NS5B inhibitor plus an NS5A inhibitor, such as sofosbuvir/ledipasvir (Bourliere, 2017). The overall SVR12 rate was 97% (146/150) in genotype 1-infected patients. SVR12 rates were 96% (97/101) for participants with genotype 1a infection and 100% (45/45) for those with genotype 1b infection. A single genotype 1-infected patient experienced relapse; this individual had subtype 1a infection and cirrhosis. Baseline RASs and the presence of cirrhosis were not significant predictors of virologic failure in genotype 1 infection. Serious adverse events were similar between the placebo and treatment arms; only 1 patient discontinued therapy due to an adverse event. Headache, diarrhea, and nausea were more common in those patients receiving sofosbuvir/velpatasvir/voxilaprevir compared to placebo.”

They mention Sovaldi and ledipasvir which you may know is Harvoni.

The drug that are talking about is called Vosevi which would be taken for 12 weeks

Another option is:

“Alternative Regimen
Glecaprevir/Pibrentasvir
In parts 1 and 2 of the MAGELLAN-1 trial, 42 genotype 1-infected patients had previously been treated with either an NS5A inhibitor or an NS3/4A protease inhibitor (Poordad, 2017); (Poordad, 2017b). Twenty-four percent of these patients had cirrhosis and 79% were genotype 1a infected. Patients who were previously treated with an NS5A inhibitor (ledipasvir or daclatasvir) and not concomitantly treated with a NS3/4A protease inhibitor were retreated with the daily fixed-dose combination of glecaprevir (300 mg)/pibrentasvir (120 mg) administered as three 100 mg/40 mg fixed-dose combination pills for 16 weeks. Among these patients, 94% (16/17) achieved SVR 12. The single patient who did not respond to therapy had an on-treatment virologic failure. Due to the 16-week duration of therapy and limited supporting data, this is recommended as an alternative regimen.”

The trade name for this drug is Mavyret.

So all is not lost you can still beat this thing. See your doctor and decide where to go from here.

Hello, I'm very sorry that this happened. I think it's a shocked for you and your doctor.
The drug Harvoni consists of Ledipasvir is an inhibitor of NS5A, a hepatitis C virus protein and Sofosbuvir is in the nucleotide inhibitor the NS5B protein.
I did for HCV the of the routine testing of drug resistance (NS3,NS5A,NS5B) prior to the use of the new treatment regimens.
It was necessary for me to avoid failure.

I just found my 8 weeks on Harvoni failed as well. I think the bigger issue is 12 would be better. The insurance does not want to pay for 12 if they can help it. I am starting over now I am very unhappy about it.
Brad

I had answered earlier on this post. But, to give you an update. After 12 failed treatments, I finally got the cure on Vosevi. Vosevi came out after Harvoni. Unlike Harvoni which has 2 drugs in one pill.., Vosevi has 3 drugs in one pill. It took 20 yrs, but I am finally Hep C free! So, yes, I would definitely recommend Vosevi. I had barely any side effects at all to even mention.

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